Objective: A recent systematic review reported that up to 71% of patients with growth hormone deficiency and their families are non-adherent to treatment as prescribed. Non-adherence to growth hormone treatment presents a substantial and costly problem for the patient, healthcare provider and healthcare system. The current study uniquely investigates the potentially modifiable factors associated with treatment non-adherence in this endocrine disorder. Methods: The cross-sectional study was conducted among 82 parent/caregivers of children with growth hormone deficiency and receiving growth hormone treatment. Self-report questionnaires investigated parents/caregivers’ perceptions and experiences of their child’s condition and prescribed treatment, in addition to their perceived relationship with their healthcare professional. The eight-item Morisky Medication Adherence Scale was used for the assessment of treatment adherence. Results: 62% of parent/caregivers were found to be non-adherent to growth hormone treatment as prescribed. Illness perceptions [consequences, identity and coherence] and treatment concerns were found to be significantly associated with treatment adherence, as was the quality of the healthcare professional-parent/caregiver relationship. Conclusion: The study confirms the extent of the adherence problem evident amongst the paediatric growth hormone deficiency population. In addition, it presents an insight into the explanatory factors that underpin non-adherence to growth hormone treatment. Our findings can be used to inform the development of adherence-focussed interventions, with the purpose to support patients and their families and improve the use of prescribed growth hormone treatment within endocrine clinical practice. Abbreviations: GHD = Growth Hormone Deficiency; rhGH = Recombinant Human Growth Hormone treatment; HCP = Healthcare Professional; MMAS = Morisky Medication Adherence Scale; BIPQ = Brief Illness Perception Questionnaire; BMQ = Beliefs about Medicines Questionnaires-Specific; PHR = Parent-Healthcare Provider Relationship-AIRS© Section II; COM-B = Capability, Opportunity, Motivation – Behavior.
Effect of adherence to growth hormone treatment on 0–2 year catch-up growth in children with growth hormone deficiency
